Transfusion-transmitted infections among northern Saudi blood donors: Seroprevalence and risk factors

Transfusion-transmitted infections (TTIs) remain a challenge to public health, especially in settings with diverse populations and unequal access to healthcare. In Saudi Arabia, limited data have been collected on national TTI screening efforts. The objective of this study was to determine TTI seroprevalence and associated risk factors among blood donors in Hail, a city in northern Saudi Arabia. We performed a retrospective analysis of data representing blood donors who visited the Maternity and Children Hospital in Hail from January 2020 to December 2023. These data represented 3168 total donors. Serological screening and nucleic acid testing (NAT) for hepatitis B and C, human immunodeficiency virus, human T-lymphotropic virus, syphilis, and malaria were performed for all donors. Bivariate and multivariate logistic regression models were constructed to evaluate sociodemographic and donation-related variables. The overall prevalence of TTI was 2.11%. The most frequently discovered TTI was the hepatitis B surface antigen (1.60%). No infections were detected using NAT that were not identified with the serological assays. Non-Saudi nationality (adjusted odds ratio = 5.36), rural residence (adjusted odds ratio = 3.63), and increasing age were independent predictors of TTI positivity. The prevalence of TTIs was greater in voluntary donors (2.31%) than in family/replacement donors (0.32%), which we attributed to the dominance of 1st-time donors. An increasingly linear decrease in TTI prevalence was observed to correspond with a higher donation frequency (P < .001). The overall TTI prevalence was low. However, the noteworthy differences in TTI burden by nationality, place of residence, and place of donation underline the need for reinforcing donor-specific screening, donor retention programs, and health education. The widespread administration of NAT in this study validated the safety of the blood supply and highlights the value of local, regional, and national transfusion services.